Individual
MOHAMED ELGAMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 676-4444
(812) 676-4445
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01089523A
IN
207R00000X
Internal Medicine Physician
4301113553
MI
207RH0003X
Hematology & Oncology Physician
01089523A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540867
MEDICARE PTAN
IN
01
—
Q00539106
RAILROAD PTAN
IN
Enumeration date
08/17/2017
Last updated
09/09/2023
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